Chemotherapy Medications for Mesothelioma Treatment
For mesothelioma patients, the purpose of chemotherapy medication is to either kill or shrink cancer cells. Typically, chemo is given as a systemic treatment (i.e., medication travels throughout the body via the bloodstream). In some instances, however, the medication may be given regionally – usually, directly to the abdomen for the treatment of peritoneal mesothelioma. In most cases of mesothelioma, a combination of chemo drugs is prescribed before or after surgery or radiation therapy.
In systemic treatments, medication is given to patients each time via intravenous (IV) drip, using a small catheter inserted into the back of the hand or arm. Alternatively, doctors may insert a central line (a larger tube connected to a bigger vein in the chest or arm) for the duration of treatment. Additionally, regional chemo can be delivered through:
- Heated intraperitoneal chemotherapy (HIPEC)
- Peripherally inserted central catheter (PICC) lines
The compounds in chemotherapy medicine work by slowing or stopping cancer cells from growing, dividing, and spreading. Usually, treatment is administered in cycles over a predetermined period of time (referred to as a chemotherapy regimen). Patients might need only one drug per cycle, though doctors may prescribe a combination – certain combinations have been shown to increase life expectancy in people with mesothelioma.
Common Chemotherapy Medications
While pharmaceutical companies submit a number of medications each year for review by the Food and Drug Administration (FDA), only a fraction ever receive approval for public use – even fewer are approved for the treatment of specific cancers, like mesothelioma. For each type of the disease, researchers have developed standard chemotherapy regimens with a list of commonly-used medications (though pericardial patients may only receive palliative chemo). The FDA-approved medications for the treatment of malignant mesothelioma include:
- Alimta® (pemetrexed disodium)
- Pemetrexed disodium (generic brand)
- Gemcitabine (Gemzar®)
- Cisplatin (Platinol®)
Pleural mesothelioma is a form of cancer found in the lining of the lung cavity. Often, it is caused by the inhalation of asbestos fibers that become lodged in the lung tissue lining. After patients receive a pleural diagnosis (but have yet to receive another form of treatment), the typical regimen consists of a combination of pemetrexed (Alimta®) and cisplatin (Platinol®) or carboplatin (Paraplatin®) administered once every three weeks (known as one cycle), for four to six cycles. Additional chemo may be given to kill any remaining tumor cells or prevent their return, referred to as maintenance therapy.
Unfortunately, pemetrexed with carboplatin or cisplatin can result in uncomfortable or dangerous side effects. For these patients, one drug may be used at a time. Bevacizumab (Avastin®), a targeted therapy drug, may also be added for patients in need of additional therapy outside the most common chemo combinations.
Because peritoneal mesothelioma tumors are found in the abdominal cavity, they are often easier to reach via surgery. Subsequently, chemotherapy medications are often a complementary form of treatment for this type of cancer. Pemetrexed with carboplatin or cisplatin is still a common combination, but other medications may be used depending on the cell type.
Other drugs that may be used in the treatment of cancer (decided by a cancer care team on a case-by-case basis) include:
- Doxorubicin (Adriamycin®)
- Irinotecan (Campto®)
- Raltitrexed (Tomudex®)
- Vinorelbine (Navelbine®)
- MVP (combination of mitomycin, vinblastine, platinum)
Common Chemotherapy Side Effects
In addition to cancerous cells, systemic chemotherapy affects healthy cells too. The damage caused to healthy parts of the body often surfaces as side effects after treatment. Subsequently, the group of side effects a patient may experience typically depends on where the treatment administered. Too, factors such as how much/how often chemo is given and how the patient’s body reacts to treatment affect the presence of side effects.
Common chemotherapy medication side effects include:
- Bruise or bleed more easily
- Feeling nauseated or sick
- Hair loss
- Increased vulnerability to infection
- Loss of appetite
- Mouth sores
Sometimes, doctors aren’t able to prescribe the best treatment for the patient’s cancer in their office or hospital. The most effective treatments possible may be administered in a clinical trial – a medical research study approved by the FDA involving patient volunteers.
Current National Cancer Institute-approved clinical trials prescribing known malignant mesothelioma chemotherapy medications can be found using the links below.